I Wear Blue, Disposable Paper Surgical Gowns, Double Rubber Gloves, and a Face Mask Attached to a Battery Operated Backpack Respirator. Part Two

AN INTERVIEWWITH DR. CHARLESCALISHER.

Dr. Charles Calisher is an epidemiologist who specializes in the evolution of arboviruses, diseases transmitted by insects and other arthropods. He has served as Chairman of the Executive Council of the American Committee on Arthropod-Borne Viruses.

From 1973 to 1992, Dr. Calisher worked as Director of the World Health Organization’s Collaborating Centre for Arboviruses in the Americas, Division of Vector-Borne Viral Diseases. He served as Chief of the W.H.O.’s Arbovirus Reference Branch from 1973-1989 before taking a position as Assistant Director for International Programs at the Centers for Disease Control, Division of Vector-Borne Infectious Diseases, a position he held until 1992. Since 1996, Dr. Calisher has been Moderator for the Program for Monitoring Emerging Diseases (ProMed).

- - -

Q: Are there any unforeseen epidemic of, say, western equine encephalitis or malaria on the horizon? Is there anything brand new we wouldn’t know about?

A: As for whether there are unforeseen epidemics on the horizon, you can bet the farm on that. As we change our ecosystem with too many people, too much hog shit being put into too many rivers, too much global warming, too many trees being cut down to house and warm the too many people, we are doing things about which we know absolutely nothing. What frightens me is that there are many people who are not afraid of what we are doing. Who knows which is the one species we cannot do without? We may not even know about this species. We can cut down X number of trees but not cut down X + 1 trees. What is X?

As for whether there is anything out there that is brand new, of course. We have recognized >20 new infectious disease organisms in the past 20 years and we are recognizing them at a faster pace than in the past. More people = more hosts = more possibilities for disease. What will happen when we are transplanting organs from donor hosts such as pigs (heart valves) and primates and a pug or nonhuman primate virus gets into us, a new and susceptible host? Talk about jumping to light speed!

Q: To what extent is the spread of infectious disease related to El-Nino and other environmental trends? Is Armageddon coming?

A: As best I can tell, El Nino/Southern Oscillation phenomena are having less of an impact than the newspapers would have us believe, but I am equally certain they are having more of an impact than we realize. How could higher tides not impact coastal areas in terms not only of flooding but of destroying habitat and creating new habitats?

Armageddon is coming. First stages may even be here already and we do not recognize them. Still, no point in worrying. Better to do something. The earth is remarkably flexible. I don’t think we can count on this flexibility forever but it may be that if we do more for the earth we can help it recover from what we already have done. Ever see an open pit mine?

Q: How has your work affected your personally? Politically? For instance, do you support the privatization of health research? Do you believe health is a human right, as the World Health Organization has stated?

A: My work has paid my mortgage, paid for orthodontics for my children, paid for numerous vehicles, paid for food, clothes, paid tuitions, and paid for much more. That’s the best part. Working with infectious diseases is having job security. Other than that, my work has not affected me personally. It hasn’t changed my mind about the political side either. I started out a liberal Democrat and haven’t budged an inch. I am not enamored of people who are selfish. They surely are short-sighted as well. The guy with Ebola in Africa can be in a hospital in Chicago (or Grand Forks) within 24 hours) and that is a threat to us all. I have no problem paying taxes when they go to pay for something that is for the common good. Budgets for civilian and military medicine are far too low to make me comfortable. Except for those in Congress, chimpanzees are not numerous in North America, so I don’t worry about Ebola fever getting here on a grand scale; anyway, we could take care of it if it did. What worries me are people who think that HIV/AIDS is a disease sent to us by God as punishment for “sins”. I don’t really care what those jackasses think but I am concerned that the Religious Right has some say in funding medical research.

As for the privatization of health research, I can’t really comment. I never heard of such a God-awful idea.

No, I do not believe that health is a human right. Seems to me that health is a blessing and another advantage of having the good sense to be born to people with the good sense to live in a place where one can obtain adequate medical care. It would be lovely if everyone in the world had good medical care. However, I believe economic Darwinism is at work here. I sure wouldn’t want to live in some disgusting backwater where I and my children might die at any moment of something eminently preventable or curable. One thing we do not often enough consider in the U.S. is how fortunate we are. We have something few countries have, flush toilets with parallel piping systems. THIS is the basis for good health. That and clean air. We are losing this to the interests of the greedy.

Q: Some doctors, or people on the internet pretending to be doctors, have argued in internet news groups that vaccines don’t work well, if at all. They cite smallpox vaccines in the Philippines, where apparently a lot of vaccinated people still developed the disease. Your thoughts?

A: These people are full of crap. Most, if not all, vaccines work splendidly. There are vaccines that are less potent or to which people do not respond as well as we would like. The ultimate is a vaccine that is given in one dose and protects everyone who gets it, but there is no such thing. Vaccines are made in and of something. Sometimes purification techniques are not what we would hope for, or the rare person has an awful, unexpected, and even dangerous response to it. Hey, nothing’s perfect. One must balance the good (safe protection for most) with the bad (untoward reactions, sometimes death). Would anyone like to go back to the days when we were at the mercy of smallpox, rubella, polio, mumps, diphtheria, tetanus, and the like? I don’t think so. We will always have among us the naysayers. Finesse them.

As for batches of vaccines that do not work at all, that happens also. Yellow fever is a problem in Africa only because governments there do not have the political will to obtain the vaccine and distribute it properly. Aren’t you certain that if yellow fever was a problem in the U.S. that virus would be included in the childhood vaccination series we now give? If you build palaces for yourself, do not educate the common people, and otherwise waste money, you will not have money to purchase what you need. In some parts of Africa and South America this is exactly what happens.

Then there are breakdowns in what is called the “cool chain,” by which a vaccine gets from the source to the person in the boonies who needs it. Sometimes lots or batches are not kept at proper temperatures and they become inactivated. Doesn’t mean the vaccine wasn’t good when it was produced, just that it wasn’t good when it got to the boonies. Certainly these occurrences are not evidence that vaccines are no good.

Q: In 1982, the Center for Disease Control met with the National Hemophilia Foundation to warn them of HIV tainted blood. (At that time, the NHF was primarily made up of four U.S. companies, including Cutter Laboratories, Baxter Travenol Laboratories, Alpha Therapeutic Corporation, and a subsidiary of Revlon Cosmetics Corp. Together they apparently controlled nearly 60% of the world’s blood supply market, exporting 6 million liters a year.) At the meeting, blood bank representatives were said to have disputed the CDC’s claims of a tainted supply citing a lack of hard evidence. For the next two years debates raged between the CDC and the FDA over whether to force the NHF to implement testing measures, and hemophiliac patients as young as 7 years old died from AIDS tainted blood transfusions. Similar situations occurred regarding the government’s unwillingness to demand testing for Hepatitis.

So. . . Is our blood supply as safe as the FDA says it is? Should the Red Cross, which sold this tainted blood, or the FDA, or the NHF be charged with crimes against humanity for its failure to address tainted blood issues over the last 17 years?

A: As I said previously, nothing’s perfect. No one is perfect. Systems fail because of poor controls or new situations. These things happen. Sad when they do and it would be better if they didn’t but they do. All we can do is learn and move on. Instead, we like to sue someone. Someone surely must be responsible for everything that goes wrong. What the hell, we pay enough taxes that nothing should go wrong.

The same people who want governments off our backs want governments to intervene for them. Who’s kidding who?

The CDC is not an enforcement organization. By law, it has no teeth, just influence. It is always a great deal easier to ignore advice than to take it, particularly when it might cost you some profits. Share holders don’t like that.

Keep in mind that the CDC and the FDA are both politicized organizations. Unless this is changed nothing can be done. A senator wants the FDA to give quick approval to a drug produced in his state. What if the FDA does the right thing and doesn’t do that? What if they do what the senator wants? You decide. I like governments. I just don’t like them all and I like to keep an eye on them. I do not believe they are intrinsically evil.

I believe our blood supply is as safe as we have been able to make it. Nonetheless, were I to have a transfusion, and sufficient time, I’d want to deposit some of my own in the blood bank and only tap that supply if necessary. As I said, nothing and no one is perfect. When having surgery, a blood transfusion could be the least of your worries.

In the past years people have been given cornea transplants with rabies virus in them, and most transplant patients get infected with something; the list is long. Hey, if you are having serious surgery there must be a reason to call it “serious”. Medical procedures are not chicken soup.